A few weeks ago I had a very challenging evaluation with a football player. The athlete came in complaining of shoulder and arm pain after practice. The pain was limiting the athletes ability to actively move his arm. I cannot remember every detail of the evaluation, but I do recall my thought process as I moved throught. The athlete was saying he was in a good amont of pain and that he felt a pop as he fell on the arm. One problem I ran into was that the story of his mechanism of injury changed from the beginning of the evaluation to the end which gave me a false interpretation of what had happened. From previous experiences with the athlete, we knew he has some issues dealing with pain and is prone to coming in for injuries. As I tried to move the patients arm for mmt, rom, and special tests he said it was too painful to mive his arm more than 30 degrees in any direction. I wanted to rule out an AC joint injury, rotator cuff, and labrum, but was unable to even get him into the positions to rule these injuries out with special tests. Outside of palpation I could not figure out what to do and became very frustrated. His pain was all centered on the anterior aspect of the shoulder and "radiated" down the arm, It just so happened to be the night that Dr. Hannula was doing consulations so I took him to the clinic to see him. After his evaluation, he determined it to be a proximal clavicle fracture, which I had not even suspected. This made me even more frustrated. However, after talking to Melissa and discussing my frustration, I realized that a lot of people may have not checked for the injury based off of the symptoms he presented with. My take away from this was to realize that, even though I have a good knowledge base already, I am still a student and I still am exoected to make errors. Yes I still expect the best from myself and expect to be on target with my evaluations, but I still must allow for room for error and learning from mistakes in order to e the best clinician I can be.
Through my clinical experience over the past year and couple of months I have had a chance to see the characteristics of my preceptors in clinical practice and determine which of these I think are appropriate to adopt. One of the most important characteristics I have seen and adopted is having confidence when doing anything with the athletes. I have seen first hand that if a student acts timid or nervous around the athletes that it tends to make them very uncomfortable. This makes any situation harder to deal with as they are less likely to trust you or cooperate. I have also learned that is important to be straightforward with the athletes and not beat around the bush when it comes to injuries. One of the most important things I think I have picked up is explaining what you are doing as you go through an evaluation. Many of the athletes are interested in what you are doing and even if they are not it can beneficial to explain what you are doing and why. It is also important to not let the athletes walk over you and disrespect you. In some cases the athletes act as if we are their servants. It is crucial to let them know quickly that you are there to help, but not to wait on them hand and foot. Perhaps the most valuable thing I have picked up that will help me throughout my education and career is to always try to have a positive attitude or mood. Even when you are having a bad day, having a positive attitude while you are in clinical experience makes everyone's time more bearable. Everyone is tired and stretched thin, so it does nothing to come in and act like a brat.
My second goal for the year is to improve my knowledge of evaluation skills and execution of special tests in order to become more accurate in diagnosing injuries. I definitely feel like this is progressing as the semester goes. With each evaluation I am becoming more comfortable with moving through them smoothly. I have also been spending some time looking over my special tests and making some new notes as I perform them and feel some of the different results. With each evaluation, I notice it becoming easier to focus more on moving through the process without having to stop and think and gather my thoughts. It seems as though finding one thing quickly leads me to another thing to try. These sequences are also leading me to more accurate assessments.
So far I feel like I am meeting my packet goals better than I have before. This past week I definitely slowed down on my attempts as I did not get to see very many injuries, whereas the previous weeks I had been seeing a ton. I feel like now I can do better and it is time to start practicing my skills through some scenario based situations in order to make up for not seeing actual injuries. I am still wanting to obtain ten masteries per week and will more than likely have to use the scenarios to hit that mark.
There were a lot of cool things that I had the chance to do this week, but I chose the course objective of demonstrating reliability, dependability, and initiative for something interesting, or at least that I think is interesting, that happened at Ferrum. This falls under the initiative for the most part. When we arrived at Ferrum on Saturday we found out that we only had one taping table/station for all of our athletes. There were two Athletic Trainers and three students, including myself, that were going to have to tape in the space. While we were figuring out our plan for getting everyone through, I noticed a conditioning room next to our space that was full of equipment. I got the idea of building a taping station out of what I saw. I ended stacking some box jump platforms and some flat platforms that they had and making a two sided taping station in a narrow hallway. I know it may seem kind of strange that I wrote about this over an evaluation or injury, but it's the cool ingenuitive things such as this that makes Athletic Training so much fun. Many times on our road games we are not always in the best situation to get athletes the pre-treatment that they need, but we always figure out a way to do it. The athletes got a big kick out of it and I did as well. On top of that I would like to add a part about responsibility and dependability. Between the Athletic trainers and AT students who traveled, I was the only male. This meant I was in the locker room post-game doing a lot of things by myself. I was originally in there to give out water and cut tape, but in the midst of that an athlete got a sever cramp in his leg and I got to help him out by myself. These situations influence me by building my confidence and ingenuity in ways that other normal scenarios do not. It teached me to be creative and to make the best of the situation as well as to be independent in many situations. Again, I know these may not be the most exciting things to some, but I thought they made for a neat little story.
Each week, the students in our Athletic Training Program are required to post a journal entry. These can be typed our video recordings. Each week we focus on a different topic relating to clinicals, research, EBP, classes, or life in general. We are also graded through our websites, so if you notice any weird notes or things that do not make sense it is probably part of an assignment. Take a minute to check them out!